多发性骨髓瘤早期发现的实验室研究探讨  

Laboratory study on early detection of multiple myeloma

作　　者：寻治铭[1] 许雨璐 王金英[1] 申曼[2] 黄仲夏[2] 李晓阳[1] XUN Zhiming;XU Yulu;WANG Jinying;SHEN Man;HUANG Zhongxia;LI Xiaoyang(Department of Clinical Laboratory,Jingxi District of Beijing Chaoyang Hospital,Beijing 100043,China;Department of Hematology,Jingxi District of Beijing Chaoyang Hospital,Beijing 100043,China)

机构地区：[1]北京朝阳医院京西院区检验科,北京100043 [2]北京朝阳医院京西院区血液科,北京100043

出　　处：《国际检验医学杂志》2023年第1期84-88,共5页International Journal of Laboratory Medicine

摘　　要：目的比较多发性骨髓瘤(MM)患者与健康体检人员的实验室数据差异性,分析MM患者的实验室检测数据特点,为健康人群中早期发现MM提供依据。方法收集2017年1月至2021年12月在该院确诊的100例初发MM患者(病例组)与同时期100例健康体检人员(对照组)的血常规与血清生化检测结果,通过上述指标结果进行比较分析,差异有统计学意义(P<0.01)的指标进行二元Logistic回归分析,找出对MM独立危险因素的实验室指标,并通过受试者工作特征(ROC)曲线进行分析其曲线下面积(AUC)特异度和灵敏度,求出阈值。结果MM患者均以骨痛和乏力为常见症状,单因素分析显示,病例组和对照组除碱性磷酸酶(ALP)、乳酸脱氢酶(LDH)、三酰甘油(TG)、中性粒细胞绝对值(NEUT)、单核细胞绝对值(MONO)外,其他差异均有统计学意义(P<0.01),二元Logistic回归分析得到血红蛋白(Hb)(P<0.001),尿酸(UA)(P=0.028,<0.05),高密度脂蛋白(HDL)(P=0.001,<0.05),球蛋白(GLB)(P=0.004,<0.05)为MM独立的影响因素,通过ROC可以看出Hb(AUC=0.932,灵敏度为0.82,特异度为0.93),HDL(AUC=0.791,灵敏度为0.65,特异度为0.80),GLB(AUC=0.723,灵敏度为0.61,特异度为0.99)三者在预测MM上有较高的准确性。结论实验室指标Hb、GLB、HDL、UA联合共同分析,对MM的早期诊断有重要参考价值。Objective To compare the difference of laboratory data between multiple myeloma(MM)patients and healthy people,and to analyze the characteristics of laboratory test data of MM patients,so as to provide evidence for early detection of MM in healthy people.Methods The blood routine and serum biochemical detection results of totally 100 patients with primary MM diagnosed in the hospital from January 2017 to December 2021(case group)and 100 healthy persons in the same period(control group)were collected and compared.The indicators with significant difference(P<0.01)were screened out for binary Logistic regression analysis,and the laboratory indicators for independent risk factors of MM were found.The specificity and sensitivity were analyzed through the receiver operating characteristic(ROC)curve,and the threshold was calculated.Results The common symptoms of MM patients are bone pain and fatigue.Univariate analysis showed that,except for alkaline phosphatase(ALP),lactate dehydrogenase(LDH),triglyceride(TG),neutrophilic granulocyte absolute value(NEUT)and monocyte absolute value(MONO),the differences on the other indexes between the case group and the control group were statistically significant(P<0.01).Binary Logistic regression analysis showed that hemoglobin(Hb)(P<0.001),Uric acid(UA),(P=0.028,<0.05),high-density lipoprotein(HDL)(P=0.001,<0.05),globulin(GLB)(P=0.004,<0.05)were independent influencing factors of MM.According to ROC curve,Hb(AUC=0.932,with sensitivity of 0.82,specificity of 0.93),HDL(AUC=0.791,with sensitivity of 0.65,specificity of 0.80),GLB(AUC=0.723,with sensitivity of 0.61,specificity of 0.99)had relatively high accuracy in predicting MM.Conclusion The combined analysis of Hb,GLB,HDL-C and UA has important reference value for the early diagnosis of MM.

关 键 词：多发性骨髓瘤 实验室诊断 二元LOGISTIC回归 早期发现 

分 类 号：R733.3[医药卫生—肿瘤]